Mothers Who Exclusively Formula-Feed Don’t Get More Sleep

Summary
It is known that babies who are exclusively breastfed wake up more often and sleep less; but little is known about how the feeding method affects a mother’s sleep. This study took a look at various methods of feeding, like breastfeeding and formula feeding, and their effects on a mother’s sleep and daytime functioning. The results did not show any differences in sleepiness or fatigue among women who used different feeding methods. According to the researchers, “Efforts to encourage women to breastfeed should include information about sleep. Specifically, women should be told that choosing to formula feed does not equate to improved sleep.”

Introduction
The American Academy of Pediatrics (AAP) recommends breastfeeding for the “best possible health as well as the best developmental and psychosocial outcomes for the infant. Because of its well-established benefits for both infants and mothers, any perceived disadvantage of breastfeeding should be evaluated carefully.” Breastfeeding may concern a mother regarding loss of sleep and hence she may choose to formula feed her baby. Such concerns of the mother are legitimate and require understanding. However, the effect of feeding methods on maternal sleep has not been studied in depth in the past. This study was undertaken to assess the correlation of feeding type and sleep.

Methodology
* Pregnant women and new mothers with healthy babies less than a week of age were included in the study.
* Those who were suffering from psychiatric ailments like depression or anxiety were not included in the study since these factors can affect sleep patterns.
* Assessments were made by a telephone interview where the researchers asked the mothers questions regarding the feeding of their baby, based on which they divided them into three groups: “mothers who breastfed exclusively,” “mothers who used formula exclusively,” and “mothers who used a combination of the two methods.”
* All mothers were then given questionnaires and a wrist monitor (Actiwatch-64) to record their sleep time and patterns, and also their levels of fatigue during the day.

Results
* The results showed that mothers who used both feeding methods had greater sleep efficiency than did those who used formula feeding alone.
* Results also showed that sleepiness and fatigue during the day time was almost similar in all feeding groups.
* To explain for more awakenings of breastfeeding mothers but equal sleep effectiveness and fatigue the authors write, “despite their self-reports, breastfeeding mothers are awakening more often during the night to feed their infants but they return to sleep more quickly or sleep during feedings and consequently do not remember those awakenings.”

Shortcomings
Authors admit that there are other factors, aside from sleep, that influence how a baby is fed by its mother. Some of these were not discussed in detail in this study. They include the mother’s depression, anxiety, educational qualification, income and age. As a result these findings may not be generalized for all groups of mothers. Also the scale used to assess sleep in this study has not been tried exclusively with new mothers in the past, and the authors admit that this could have led to some differences in results.

Conclusion
Though there is little evidence to support that breastfeeding can have an effect on a mother’s sleep, all “efforts to encourage women to breastfeed, as currently endorsed enthusiastically by the American Academy of Pediatrics, should include information about sleep.” Particularly, all new mothers must be informed that they need not choose to formula feed in order to sleep better, since all methods of feeding lead to equal sleep, or lack of it. Counseling of new mothers should include information regarding the adverse health risks that are posed to the baby by not breastfeeding, and given formula instead, in order to be able to sleep better.